Laser retinal injury hazards are present in a variety of military settings. Incident reports abound from adversarial cockpit illumination to battlefield laser rangefinders and target designators as well as episodes of laser injury in government laboratories involved with high energy physics research or other scientific pursuits. Stuck, B. E., H. Zwick, J. Molchany, D. Lund, D. A. Gagliano, “Accidental human laser retinal injuries from military laser,” SPIE 2674(7), pp. 7-20 (1996); Zwick H, B. E. Stuck, W. Dunlap, D. K. Scales, D. J. Lund, J. W. Ness, “Accidental bilateral Q-switched neodymium laser exposure: Treatment and recovery of visual function,” SPIE 3254, pp. 80-89 (1998). The development of subretinal neovascular membranes represents one of the most vision threatening complications of laser injury.
Currently, treatment of neovascular membranes involves patient rotation through separate stations in order to first diagnose then perform therapeutic membrane ablation using photodynamic therapy (PDT). Treatment involves a cut and paste methodology, with eye care providers estimating lesion size from images generated by the initial patient evaluation. Therapy then occurs with a separate instrument in the general vicinity of suspected retinal involvement. This frequently leads to missing portions of the neovascular membrane resulting in further vision loss and the need for repeat treatments. Thus, current schemes for application of light to produce dye-activation often result in under-treatment and recurrence of the underlying neovascular membrane.